eMedicine Specialties > Clinical Procedures > Musculoskeletal Procedures

Splinting, Thumb Spica

Author: Rick Kulkarni, MD, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Contributor Information and Disclosures

Updated: May 5, 2009

Introduction

In general, splints are applied to decrease movement and provide support and comfort through stabilization of an injury.1  Splints are primarily used to secure nonemergent injuries to bones until they can be evaluated by a consultant such as an orthopedic surgeon. Splints are also used to temporarily immobilize an extremity prior to surgery (eg, open fracture) or to assist in primary healing. Unlike casts, splints are noncircumferential and often preferred in the emergency department setting, since injuries are often acute and continued swelling can occur. All patients with injuries that are splinted should be referred for evaluation by a consultant in a timely fashion (usually within 2-7 days, depending on the reason for the splint).

Indications

A thumb spica splint can be used for various injuries that include the following:

Contraindications

  • Absolute contraindications – None 
  • Relative contraindications in injuries that require immediate evaluation or intervention by a consultant (eg, orthopedic surgeon, hand surgeon, plastic surgeon)
    • Complicated fractures
    • Open fractures
    • Injuries with associated neurovascular compromise

More on Splinting, Thumb Spica

Overview: Splinting, Thumb Spica
Treatment & Medication: Splinting, Thumb Spica
Multimedia: Splinting, Thumb Spica
References
Further Reading
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References

  1. Howes DS, Kaufman JJ. Plaster splints: techniques and indications. Am Fam Physician. Sep 1984;30(3):215-21. [Medline].

  2. Hannibal M, Roger D. Gamekeeper's Thumb. http://emedicine.medscape.com/article/1239413-overview. eMedicine from WebMD [serial online]. November 2, 2007;Accessed May 5, 2009. Available at http://emedicine.medscape.com.

  3. Kaplan SS. Burns following application of plaster splint dressings. Report of two cases. J Bone Joint Surg Am. Apr 1981;63(4):670-2. [Medline].

  4. Chudnofsky C, Byers S. Splinting techniques. In: Roberts J, Hedges J. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia: WB Saunders Company; 2004:989.

  5. Menkes J. Initial evaluation and management of orthopedic injuries. In: Tintinalli J, Kelen G, Stapczynski J. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York: McGraw-Hill Professional; 2003:1651.

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Further Reading

MedlinePlus: Hand Injuries and Disorders

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Keywords

thumb spica, splinting, thumb fracture, broken thumb, broken metacarpal, gamekeeper’s thumb, scaphoid, lunate, ulnar collateral ligament, metacarpal fracture, splinting, de Quervain tenosynovitis, UCL strain, wrist flexors, flexion contracture, wrist immobilization, wrist extensors, plaster splint, thumb injury, anatomical snuffbox, occult fracture, scaphoid injury, axial load, MCP, UCL injury, UCL weakness

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Contributor Information and Disclosures

Author

Rick Kulkarni, MD, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

Medical Editor

Andrew K Chang, MD, Associate Professor, Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center
Andrew K Chang, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Neurology, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Luis M Lovato, MD, Associate Clinical Professor, David Geffen School of Medicine at UCLA; Director of Critical Care, Department of Emergency Medicine, Olive View/UCLA Medical Center
Luis M Lovato, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

Gil Z Shlamovitz, MD, Assistant Professor of Emergency Medicine, University of Connecticut School of Medicine; Attending Physician, Emergency Department, Windham Community Memorial Hospital, Willimantic, CT; Attending Physician, Emergency Department, Hartford Hospital, Hartford, CT
Gil Z Shlamovitz, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians
Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Disclosure: Nothing to disclose.

 
 
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